Managing Vascular Dementia Risk Factors with SymTrend

Project Summary AbstractAbstractDiseases of blood vessels in the brain culminate in vascular dementiaVaDand ultimately rob one of independence in activities of daily living in elder yearsThey often commence an insidious progression in early to midlife with a concomitant diminution in work proficiencyVascular dementia is treatablehoweverSuccessful containment of the progression requires rigorous management of associated health riskssuch as control of blood sugarsweight lossreduction of blood pressure levels and of alcohol consumptionsmoking cessationimproved dietand increased exerciseManagement of these health risks is highly effective in halting cognitive decline and preserving ADL independenceHoweverconsistent health management is nearly impossible to achieve in most patients with vascular mild cognitive impairmentthe early stage of vascular dementiawho are still living independentlyIn this proposalwe aim to enhance SymTrenda currently marketed electronic diary systemto help this vast under treated aging populationWe propose to tailor SymTrend to VaD risk factors add links to inexpensive Bluetooth and open source data enabled devicese gBP monitorsand apps and to optimize real time trackingfeedbackand guidance for managing these health risksObjectivesWe will add four components to SymTrendlinks to Apple Health and Bluetooth devicesexpansion of the internally programmed statistical software to improve its graphics and messaging to support patient feedback and symptom managementcreate reports that will depict progress in symptom management that are analytically useful for clinicians and can serve as the basis for patient feedbackits frequencycontentand modalitytextvoiceweb mobile displayandextend the system s analysis capabilities to detect and address vulnerabilities that arise from stressors such as family issues that impair work and activities of daily livingWe will supplement these technical features with enhanced educational material on the SymTrend websiteDesign and MethodsNeurologists from Massachusetts General Hospital will referadults with vascular mild cognitive impairment for participation in this projectThe patients will be given Bluetooth devices appropriate for their condition and will be trained to use SymTrend and Apple Health softwareThey will use the software and devices for three monthswill receive messages throughout from the system and or a research coordinator about their progresswith encouragement and strategies to fully manage their symptomsand their neurologist will be in communication with them about the progress charts and will adjust their care on the basis of this real time dataSignificanceSuccessful completion of the technical implementation and research project will enable a care reinvention for neurologists to use with their out patients in this large population Project Narrative Individuals with uncontrolled vascular disease are at risk for an insidious progression of brain injury starting in early to midlife and ultimately culminating in a vascular dementiarobbing them of activities of daily living independenceSuccessful containment of this progression requires rigorous vascular risk factor managementthe control of blood pressureblood sugarsweightand alcohol consumptionthe cessation of smokingand an increase in aerobic activitySymTrend s mobile and web system for managing vascular risk factors will help improve adherence to health and lifestyle strategieswill stem cognitive declineand will preserve independence in the community for older adults